CLINICAL FELLOW - CORE

John Farman ICU

Addenbrooke’s Hospital Cambridge

Job Specification - May 2020

Enquiries to Dr Stephen Ford

stephen.ford1@addenbrookes.nhs.uk (JF-ICU)

Medical Staffing Department

Box 154

Cambridge University Hospitals

NHS Foundation Trust

@JVFICU Cambridge Biomedical Campus

@CamCritCareEdu Hills Road

Cambridge CB2 0QQ

Tel: 01223 256264

Critical Care Fellows - Core Applications are invited for our Critical Care Fellowships at Addenbrooke’s Hospital, Cambridge, commencing August 2020 for a period of six to twelve months. Other starting dates might be considered. These fellowships focus on the work of the prestigious tertiary ICU the John Farman ICU. The John Farman is the regional centre for transplant and hepatology ICU, in addition to providing tertiary services for other medical and surgical specialities such as vascular and hepatobiliary surgery, oncology, nephrology and haematology. Candidates must have completed their foundation programmes or equivalent. These posts are particularly suitable post for doctors considering careers in ICM, anaesthesia or another acute speciality. The working pattern involves clinical work (including nights and weekends) on the John Farman ICU. The John Farman ICU rota currently involves 1:2 weekends, but we are actively seeking to improve the weekend component of the rota. Consultant support is available 24 hours a day. Opportunities exist for supernumerary placement with the Rapid Response Team. All fellows are allocated clinical supervisors and offered similar training opportunities to trainee doctors. Opportunities exist for career advancement through quality improvement projects, teaching, and training in Intensive Care Echocardiography and Thoracic Ultrasound. It may be possible, depending on circumstances, for fellows to rotate to our sister unit at Addenbrooke’s, the NeuroCritical Care Unit (NCCU).

The John Farman ICU and Rapid Response Team

The John Farman Intensive Care Unit (JVF ICU) is a 20-bedded Critical Care Unit admitting 1000 adult patients annually. The medical case mix reflects the complex nature of the patients within Addenbrooke’s: significant numbers of admissions are from hepatology, haematology, nephrology and transplant medicine. Addenbrooke’s performs around 100 liver transplants annually and is the UK’s sole multivisceral transplant centre. Patients are admitted to the JVF ICU from all major specialties excluding cardiothoracics and neurosurgery.

The Rapid Response Team (RRT) successfully provides emergency support for deteriorating patients throughout the hospital. The RRT also provides medical cover for four dedicated HDU beds to allow rapid stabilisation of critically ill patients.

There are regular multidisciplinary clinical governance and audit meetings. The unit is recognised for training at all levels in ICM by the GMC, and participates in the ICNARC case mix programme. There is a weekly ICU follow up clinic and monthly audit programme.

Effective and multidisciplinary team-working is integral to the JVF ICU. We have an establishment of more than 100 WTE nurses, a specialist physiotherapist and dedicated pharmacist. Microbiology and radiology rounds are held each day on the unit.

ICU and RRT consultants are on-site 08:00-20:00 seven days a week and available on-call 24 hours a day. We are dedicated to supporting our junior medical staff.

Teaching and Training

The JVF-ICU unit has an active educational programme with weekly trainee- and consultant-led sessions. In addition there are twice yearly study days organised by the Cambridge Critical Care Education Group. There is also the opportunity for training in echocardiography for fellows who have undertaken FICE or equivalent courses.

The John Farman ICU and Rapid Response Teams

The present JVF-ICU medical staff establishment comprises

Consultants

Dr Andrew Johnston - Speciality Lead Consultant in ICM, anaesthesia & vascular access

Dr Peter Bradley Consultant in ICM, anaesthesia & vascular access

Dr Andrew Conway Morris Honorary Consultant in ICM, senior research associate

Dr Peter Featherstone Consultant in ICM & anaesthesia

Dr Stephen Ford Consultant in ICM & anaesthesia

Dr Milena Georgieva Consultant in ICM & anaesthesia, lead for echocardiography

Dr Razeen Mahroof Consultant in ICM & anaesthesia, lead for e-hospital Dr Jonathan Martin Consultant in ICM & anaesthesia, lead for ICNARC

Dr Vilas Navapurkar Consultant in ICM & anaesthesia

Dr Kamal Patel Consultant in ICM & acute medicine

Dr Jacobus Preller Consultant in ICM & acute medicine, research interest Dr Charlotte Summers Honorary Consultant and University Lecturer in ICM Dr Monica Trivedi Consultant in ICM & anaesthesia, lead for RRT and follow-up

Dr James Varley Consultant in ICM, anaesthesia & vascular access, FICM tutor

Junior medical staff Junior fellows will primarily be allocated to ICU but, when possible, can have supernumerary

experience with the RRT.

Junior doctors rotate through a rota that currently includes 1:2 weekends. We are actively attempting to make the rota compliant with this aspect of the new rota regulations.

12 Specialty Registrars/ clinical fellows

5 CT1’s/CT2’s

3 Foundation Doctors (FY1s and FY2s)

The City of Cambridge The City of Cambridge is the seat of one of the ancient European universities and is one of the fastest growing cities and economies in the country due to the interplay between the university, hospital and knowledge-based industries. It has developed a reputation as one of the best small cities in the UK due to the numerous cultural experiences, scenic city.

Critical Care Research at Addenbrooke’s

Professor David Menon holds Chair and is Head of the Division of Anaesthesia at the University of Cambridge, principal investigator in the Wolfson Brain Imaging Centre, and co-chair of the Acute Brain Injury Programme at the University of Cambridge. His research interests include traumatic brain injury, neuroinflammation and neuroimaging.

Dr Jon Coles is University Lecturer at the University of Cambridge. His research interests are the pathophysiology of various forms of brain injury and optimising patient outcome.

Dr Charlotte Summers is the University Lecturer in Intensive Care Medicine at the University of Cambridge. Her research interests lie in ARDS and neutrophil biology, in addition to translational medicine projects.

Dr Ari Ercole has a particular research focus on applications of systems biology in intensive care medicine and anaesthesia. He is particularly interested in measurement and modelling cerebral perfusion, oxygenation and metabolism after traumatic brain injury.

Dr Andrew Conway Morris is Senior Research Associate at the University of Cambridge and is currently researching immune dysfunction in the critically ill, and the diagnosis and management of nosocomial infections.

Both units recruit patients into portfolio multi-centre studies and is supported by a dedicated research nurse, Petra Polgarova. Fellows who wish to become involved in the unit’s research may be provided some time free from clinical commitments to facilitate this. The trust can provide research training in Good Clinical Practice to research-active staff.

Job and Personal Specification Entry Criteria Essential Desirable

Qualifications MBBS or equivalent qualification

Full Registration and a Licence to Practice with the General Medical Council at time of appointment

ATLS Course

CCrISP

Presentations/Publications

Experience Completion of Foundation Training Programme or equivalent

Able to deal with general emergency admissions

Skills / Ability / Knowledge

Basic surgical skills and patient care

Competence in pre-operative and post-operative management of general surgical patients

Good organisation

Enquiring, critical approach to work

Basic computer skills including Microsoft word and

Outlook

Qualities / Attributes

Ability to work as part of a team

Ability to keep good medical records and communicate with other hospital departments and primary care

Ability to understand and communicate with patients

and colleagues

Ability to undertake research projects and audit

Show interest in

investigative, audit and research work outside

immediate clinical responsibility

Language Requirements

The applicant must have demonstrable skills in listening, reading, writing and speaking in English that enable effective communication about medical topics with patients and colleagues, as set out in the GMC’s

Good Medical Practice (2014)

If the Primary Medical Qualification including clinical contact was not carried out using English, applicants

must either:

• Have an academic IELTS score of at least 7.5 in each domain and overall, or demonstrate equivalence by

providing evidence of English language skills. or

• Complete the Occupational English Test (OET) and achieve grade B in each of the four domains tested in

the OET to meet the GMC’s requirements.

General Information Cambridge University Hospitals NHS Foundation Trust (CUH) in profile

We are one of the largest and best known acute hospital trusts in the country. The ‘local’ hospital for our community, delivering care through Addenbrooke’s and the Rosie, CUH is also a leading regional and national centre for specialist treatment. The hospital fulfils a number of important functions; its three main core actives are clinical care, research and teaching. It is the local hospital for people living in the Cambridge area, providing emergency, surgical, medical and maternity care but as well as delivering care, it is also:

A leading national centre for specialist treatment for rare or complex conditions such as organ transplantation, cancer, neurosciences and paediatrics. (For further information about clinical services www.cuh.nhs.uk/services-0)

A government-designed biomedical research centre and part of the National Institute for Health Research (NIHR)

One of six academic health science centres in the UK

A university teaching hospital with a worldwide reputation

A partner in the development of the Cambridge Biomedical Campus. Our vision is to improve people’s quality of life through innovative and sustainable healthcare. Our CUH Together Strategy has been developed with staff, patients and partners. Patients are central to everything we do and we want to ensure that CUH is an exciting and supportive place to work. Our vision is to improve people’s quality of life through innovative and sustainable healthcare. We will deliver our vision in a way that is consistent with our values of Together – Safe | Kind | Excellent, and the associated behaviours that define how we care for our patients and work with our colleagues and partners. Our strategy has four key priorities:

• Improving patient journeys • Working with our communities • Strengthening the organisation • Contributing nationally and internationally

We share our site with a range of other organisations including the University Clinical School, the National Blood Authority, and laboratories funded by the Medical Research Council (MRC), the Wellcome Trust and Glaxo SmithKline, University of Cambridge Hutchison/Cancer Research UK (CRUK) Cancer Centre and The Medical Research Council’s

facility to house the Laboratory of Molecular Biology. The most recent addition is Royal Papworth Hospital which relocated to the Campus in April 2019. Building is currently underway on a new global R&D Centre and Corporate HQ for AstraZeneca. In December 2018 it was announced that The Cambridge Childrens Hospitals will be added to the campus, the first phase is due to be open by 2023. The Childrens Hospital vision is to treat the whole child, not just the illness or condition. The children’s hospital project will be delivered through an innovative joint proposal between ourselves, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), providing mental health services and the University of Cambridge, providing world-leading academic research. We are acutely aware that this hospital needs to provide support to develop and strengthen paediatrics across the whole region and we will be working with our networks to build a shared vision for this. The partnership is pioneering the full integration of physical and inpatient mental healthcare in the same setting, alongside ground breaking genomic science and mind and body mental health research to find new ways of preventing and detecting childhood diseases. The hospital will provide a permanent and sustainable home for CPFT’s inpatient children and young people’s mental health services currently provided on the Ida Darwin site in Cambridge. It is an exciting time for the city and the region. For us at CUH, being based at the heart of the Cambridge Biomedical Campus means we are perfectly situated to make the most of the opportunities that are arising. We pride ourselves on the teamwork, energy and commitment of our excellent staff – they are our most important assets. Recognising this, we have taken a positive approach to supporting them in their work through schemes to help work-life balance, improvements in the working environment and initiatives to make it easier for staff to explore new career opportunities and to develop professionally and personally. Cambridge University Hospitals - Board of Directors Chair and Chief Executive: Dr Mike More – Chair Roland Sinker – Chief Executive Non-Executive Directors: Daniel Abrams Adrian Chamberlain

Dr Annette Doherty Dr Michael Knapton Professor Sharon Peacock Doris Olulode Executive Directors: Nicola Ayton - Director of Strategy and Major Projects Dr Ewen Cameron – Director of Improvement and Transformation Jon Scott – Interim Chief Operating Officer Paul Scott – Chief Finance Officer Dr Ashley Shaw – Medical Director Lorraine Szeremeta – Chief Nurse Ian Walker – Director of Corporate Affairs David Wherrett – Director of Workforce Cambridge University Hospitals NHS Foundation Trust in detail Last year 70,665 men, women and children were treated as inpatients, 121,871 people attended accident and emergency, and there were 818,893 visits to outpatient clinics (2018-2019 figures). CUH medical staff hold clinics in 14 different regional hospitals so that patients do not have to travel to Cambridge. Nearly 100 of our Consultants hold some form of joint appointment with a dozen neighbouring hospitals. CUH is a teaching hospital for medical undergraduates and postgraduates, nurses and students in other clinical professions and has a variety of initiatives to encourage life-long learning’. Many training schemes are in place in our National Vocational Qualification Centre, Postgraduate Medical Education Centre and Learning Centre. Training schemes include cadet schemes in nursing, office technology, science, modern apprenticeships in clinical engineering and supporting training placements for biomedical scientists. CUH has:

Around 11,000 staff of which 1,400 are medical and dental staff

5,330 births per year

Around 1,000 beds

185,136 inpatient admissions including births

121,871 Emergency Department attendances (2018/2019 figures)

Addenbrooke's history Addenbrooke's was one of the first provincial, voluntary hospitals in England. The Hospital opened its doors in 1766 with 20 beds and 11 patients. Dr John Addenbrooke, a fellow and former Bursar of one of the Cambridge Colleges, left just over £4500 in his will "to hire and fit up, purchase or erect a small, physical hospital in the town of Cambridge for poor people". In 1540, two centuries before Addenbrooke's was founded, the Regius Professorship of Physic in the University of Cambridge was founded by Henry VIII. Medical training on a modest scale developed at Addenbrooke's during the late 1700s, and in 1837 (the year of Queen Victoria's accession to the throne) the hospital became a recognised school of medicine. Addenbrooke's grew rapidly during the 19th and early 20th centuries, as medical science developed. By the 1950s, the hospital was having difficulty accommodating the expansion generated by the introduction of the National Health Service. In 1959, building began on a new 66-acre site south of Cambridge, and the first phase of the Hospital was opened by Her Majesty the Queen in May 1962. Work continued to provide the majority of Addenbrooke's as we know it today, with a fully-fledged Clinical School being established in 1976. History 1766 Addenbrooke's Hospital was opened in Trumpington Street 1847 The first general anaesthetic using ether at Addenbrooke's was carried out two weeks

after it was first used in the USA 1918 Addenbrooke's welcomed its first female medical student 1962 New site on Hills Road was officially opened by the Queen 1966 The first kidney transplant in the NHS was carried out at Douglas House Renal Unit 1968 Professor Sir Roy Calne carried out the first liver transplant in the NHS 1975 The first open heart surgery was carried out at Addenbrooke's 1981 Addenbrooke’s first whole body scanner opened by Prince of Wales 1983 The Rosie Hospital was opened on the Addenbrooke’s Campus 1984 Last patient left the ‘old’ Addenbrooke’s Hospital site in Trumpington Street 1992 Addenbrooke's NHS Trust formed 1995 MRC Cambridge Centre for Brain repair opened by Duke of Edinburgh 2004 Addenbrooke's Hospital becomes a Foundation Hospital as is known as-

Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust National Centre for pancreatic surgery was opened

2006 Addenbrooke’s Hospital was named one of five National Institute for Health Research comprehensive biomedical research centres

2007 New European headquarters for Cancer Research UK based on the campus were opened by the Queen 2009 CUH and local partners in clinical care, education and research became one of the government’s new academic health science centres, forming an alliance called Cambridge University Health Partners 2009 CUH was named by Dr Foster as one of the country’s best performing trusts for

patient safety 2012 CUH is now the designated level 1 Major Trauma Centre for the East of England region 2014 Our new electronic patient record system (EPIC) was implemented at CUH making us

the first hospital in the UK to go paperless 2019 The Royal Papworth Hospital was opened by Queen Elizabeth II Positioning for the future Cambridgeshire is one of the fastest growing counties in the UK and it is estimated that the number of people over 45 years of age will rise by 55% over the next 20 years, and the county will see the continued expansion of research, business and high-tech industries. Planning is already well advanced for additional capacity to meet this growing local demand. But it is not just a matter of providing extra beds and recruiting extra staff. The hospital needs to ensure high standards of patient care by supporting training and education for staff, and work closely with NHS partners and others to ensure that care is tailored to the needs and expectations of users. This is likely to involve developing some alternatives to hospital-based care. Another challenge will be to ensure that improvements in clinical facilities keep up with the rapid pace of research investment, and that processes and governance support this growing research activity, some of which involves sensitive ethical, legal and social issues. CUH contributes to the economic strength of the greater Cambridge area as a major employer and, with our research partners, to the biotechnology sector. As a public benefit corporation, the new NHS Foundation Trust will work in partnership with other local bodies, primarily local authorities and education providers, to support sustainable economic development in the locality. Research and development

Cambridge medical research enjoys a world-wide reputation. More organisations and more individuals continue to be attracted to the city; working alongside each other they have

created one of the richest pools of clinical and scientific knowledge and expertise not only in the country but in the world. At CUH this is reflected in clinical teams working in the hospital alongside world-class scientists from a wealth of internationally renowned organisations such as the Medical Research Council (MRC) which shares the hospital campus. Doctors and scientists collaborate across disciplines and specialties and it is this co-existence of experience and expertise that fosters translational research – turning basic science into new drugs and new therapies giving patients innovative and excellent care.

We work with many partners in other NHS organisations, universities, research councils, research charities and industry to provide infrastructure and networks to build research capacity and support clinical research.

With the University of Cambridge, CUH is a partner in the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (CBRC). This partnership uses our combined strengths in biomedical science – the science that forms the basis of medicine including scientific laboratory-based knowledge and understanding – and translates them into clinical research. Established in 2007 the centre was recently awarded funding of £114.5m for 2012 to 2017. It was judged by the international selection panel as to have an outstanding breadth of world-leading investigators and represented the UK’s primary academic resource in biomedical research.

Outstanding facilities for research exist in Addenbrooke’s Clinical Research Facility (ACRC) which includes the Wellcome Trust Clinical Research Facility and the Clinical Investigation Ward. For example the CIW includes a research endosocopy suite and area dedicated to intravenous treatment including cancer chemotherapies. University of Cambridge School of Medicine The University of Cambridge School of Clinical Medicine is a major centre for biomedical research and education of world leading quality. In the most recent University Funding Council Research Selectivity Exercise Cambridge shared the highest score for any Medical School in the country. Whilst the University of Cambridge has granted medical degrees since at least 1363, the university could not offer undergraduate clinical education until the Clinical School was formally established in 1975 with purpose built accommodation at Addenbrooke’s. In addition to these facilities comprising lecture theatres, seminar rooms and first class medical library, a postgraduate education centre was opened in the Clinical School building in 1980. The most recent HEFC teaching quality assessment of the undergraduate clinical education judged the learning facilities and the teaching in the clinical school to be of the highest quality. Cambridge University Health Partners, the academic health sciences centre, in conjunction with the Institute of Continuing Education at The University of Cambridge are pleased to

offer a one year Postgraduate Certificate in Clinical Medicine to all clinicians employed in Cambridge. Further details and registration: http://www.ice.cam.ac.uk/mst-clinical-medicine General Information Cambridge is a city in the East of England, home to the University of Cambridge and one of the fastest growing technology hubs in the UK. The Arts Theatre within Cambridge is thriving and there are many musical activities to enjoy. The Fitzwilliam Museum is world famous. For those with children of school age, there is a full range of public and private education institutions covering all age groups. Cambridge is served by the national motorway network and regular train services to London King’s Cross or London Liverpool Street have a journey time of less than one hour. Within CUH, the main concourse offers shopping facilities; an advice centre; Bank; cafés; clothes boutique; financial advisory services; hairdressing salon; Marks and Spencer Simply Food; newsagent; The Body Shop; gift shop and on site solicitors. There is a Food Court which offers “fast-food”, as well as conventional options 24 hours a day. In addition the Frank Lee Leisure and Fitness club provides comprehensive facilities for swimming, racquet sports, a multi-sports hall, a floodlit outdoor multi-sports facility, gym and bar facilities. The Cambridge University Postgraduate Medical Centre has catering facilities as well as the library, lecture theatres and seminar rooms. Within the University of Cambridge, there is an unrivalled range of educational facilities, diverse cultural, sporting and other leisure activities.

General Conditions of Appointment

1. This appointment shall be governed by the Terms and Conditions of Service for Clinical Fellows at Cambridge University Hospitals 2018, as amended from time to time, and adhere to Trusts policies and procedures as appropriate.

2. All matters relating to patient’s health and personal affairs and matters of a commercial

interest to the Trust are strictly confidential and under no circumstances is such information to be divulged to any unauthorised person. Breach of Trust policy may result in disciplinary action in accordance with the Trust’s disciplinary procedure. A summary of the Trust’s Confidentiality Policy, Data Protection and IM & T Security Policy are provided in the Staff Handbook.

3. Cambridge University Hospitals NHS Foundation Trust is committed to a policy of Equal

Opportunities in Employment. A summary is detailed in the staff handbook. Any act of discrimination or harassment against staff, patients, service users or other members of the public will be subject to disciplinary proceedings which could include dismissal.

4. As an employee of a Trust, you are expected to develop the IT skills necessary to support

the tasks included in your post. You will therefore be required to undertake any necessary training to support this. As a user of Trust computer facilities you must comply with the Trust’s IM & T Security Policy at all times.

5. You are normally covered by the NHS Hospital and Community Health Services indemnity

against claims of medical negligence. However, in certain circumstances (especially in services for which you receive a separate fee) you may not be covered by the indemnity. The Health Departments therefore advise that you maintain membership of your medical defence organisation.

6. The Trust will ensure compliance with the Health and Safety at Work Act 1974. 7. The post is based on a whole time appointment calculated on an average of 40 hours

work per week; the salary for this appointment is £38,693 per annum (April 2020 figures). This is a fixed nodal pay point and does not increase incrementally.

8. In addition weekend and on-call allowances will be paid where appropriate for agreed

hours of duty within the working pattern.

9. This post is superannuable and you will be subject to the NHS Superannuation Scheme unless you chose to opt out.

a) The current rate of contribution is 7.1% for posts equivalent to F1 b) The current rate of contribution is 9.3% for posts equivalent to F2 and CF (Core) c) The current rate of contribution is 12.5% for posts equivalent to CF (Higher) Senior

Clinical Fellows 10. The successful candidate will be expected to complete a medical questionnaire and

attend the Cambridge Centre for Occupational Health at Addenbrooke’s for clearance of the form.

11. The Trust requires the successful candidate to have and maintain registration and a

license to practice with the General Medical Council and to fulfill the duties and responsibilities of a doctor as set out by the GMC.

12. With the Terms of DHSS Circular (HC)(88) – Protection of Children – applicants are

required when applying for this post to disclose any record of convictions, bind-over orders or cautions. The Trust is committed to carefully screening all applicants who will work with children and you will be expected to undertake a 'disclosure' check.

The appointment is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Act 1974 (Exemptions) Order 1975. Applicants are not entitled therefore to withhold information about convictions which for other purposes are "spent" under the provision of the Act, and in the event of employing any failure to disclose such convictions could result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered in relation to an application for positions to which the Order applies.

13. The appointment is conditional upon the following being received prior to the

commencement of employment; full occupational health clearance, satisfactory references, evidence of GMC/GDC registration, immigration status and all medical qualification.

14. This post is not recognised for training. 15. Removal expenses will be available to successful applicants within the limits of the Trust

policy.